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Anecdotal reports include mild lethargy or head-pressure during loading phases, but these are not RCT-verified

further notes that NICE CKS guidance states that treatment of B12 deficiency in people with neurologic involvement should include injections on alternate days until there is no further improvement

Additional preclinical work published in Cell Chemical Biology evaluated NNMT inhibition in similar diet-induced obesity models and confirmed the pattern: significant reductions in body weight gain, adipose tissue expansion, and circulating triglycerides compared to untreated controls

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